Clinical trials

This prospective, single-center observational study examines the relationship between perioperative nursing workload and safety-critical perioperative nursing care in the operating rooms of Agri Training and Research Hospital. Guided by the Donabedian structure-process-outcome framework, the study will directly observe eligible surgical procedures to record objective, procedure-level workload indicators (interruptions, task-switching, concurrent duties, procedure duration, shift timing, and equipment/supply shortages) together with the observed perioperative nurse's self-reported workload using the Turkish NASA Task Load Index (NASA-TLX), and a structured observation of nine safety-critical perioperative nursing care tasks (identification/procedure/site verification, allergy and critical preoperative information verification, positioning and pressure-injury prevention, normothermia, surgical counts, specimen/label verification, equipment and implant readiness, handoff, and documentation). Any delayed or omitted safety-critical care items, and any near-miss or process-deviation events identified and corrected before patient harm, will also be recorded using standardized forms. The study does not involve patients as direct research participants; only the perioperative work environment and voluntarily participating nurses are observed, and routine clinical care, staffing assignments, and surgical decisions will not be modified. The primary aim is to determine whether higher perioperative nursing workload is associated with a higher rate of missed/delayed safety-critical nursing care at the procedure level; secondary aims examine the association between missed safety-critical care and near-miss/process-deviation events, and, if sufficient events occur, whether missed safety-critical care mediates part of the relationship between workload and near-miss/process-deviation events.

This study examines the level of kinesiophobia (fear of movement) in patients undergoing elective abdominal surgery and its relationship with postoperative pain severity and early mobilization. In this descriptive, cross-sectional study, adult patients who have undergone elective abdominal surgery under general anesthesia at two centers (Agri Training and Research Hospital and Taksim Training and Research Hospital) will be assessed after completing their first postoperative mobilization (typically postoperative day 1). Kinesiophobia will be measured with the Turkish version of the Tampa Scale for Kinesiophobia (TSK), postoperative pain with the Numeric Rating Scale (NRS), and early mobilization with a researcher-developed Early Mobilization Record Form (time to first ambulation, standing duration, and first walking distance/duration). The investigators hypothesize that patients' kinesiophobia levels will be positively associated with postoperative pain severity and with delayed/reduced early mobilization, and that patients without prior surgical experience will have higher kinesiophobia levels than those with prior surgical experience.

Perianesthesia (preoperative and postanesthesia care unit, PACU) nurses work rotating, often extended shifts that can disrupt sleep and increase fatigue, both of which are recognized threats to patient safety in high-acuity perioperative settings. Mindfulness, a trait-like capacity for present-moment, non-judgmental awareness, has been proposed as a psychological resource that may help nurses regulate attention and buffer the effects of sleep loss and fatigue on clinical performance. However, little is known about how sleep quality and quantity, shift-level fatigue, and mindfulness jointly relate to the day-to-day safety performance of perianesthesia nurses. This prospective, repeated-measures, single-center study examines the relationships among sleep, mindfulness, and shift-level safety performance among nurses working in the perianesthesia/PACU care areas of Ağrı Training and Research Hospital. Approximately 25 to 40 perianesthesia nurses will be followed across 8 to 12 of their own shifts each, with a target of 250 to 300 evaluable shift-level observations. At baseline, nurses will complete a demographic form together with the Pittsburgh Sleep Quality Index (B-PSQI) and the Mindful Attention Awareness Scale (MAAS). Before each observed shift, nurses will complete a brief pre-shift sleep and sleepiness diary; after each shift they will complete a post-shift acute-fatigue and shift-characteristics form. For each observed shift, trained researchers will use a researcher-developed Perianesthesia Safety Process Observation Form to document adherence to, and deviations from, applicable safety-critical care processes. The primary outcome is the Shift-Level Perianesthesia Safety Deviation Rate, defined as the number of observed safety-process deviations divided by the number of applicable safety processes for that shift. Secondary outcomes include post-shift acute fatigue, the occurrence of near-miss events, and exploratory analyses of whether trait mindfulness moderates the associations between sleep/fatigue and safety performance. No patients are directly enrolled as research subjects; only nurses and their shifts are observed. Findings are expected to inform strategies to support nurse sleep, wellbeing, and safety-critical performance in perianesthesia settings.

This study evaluates the effect of the Reality-Integrated Quality Education (GENE) approach, an educational intervention using sensory restriction simulations (vision, hearing, speech, and movement restriction), on empathy, communication skills, patience, psychological resilience, and patient-centered care competency among third-year nursing students. Sixty nursing students will be randomly allocated to an experimental group (n=30), who will complete a single 30-45 minute GENE simulation session, or a control group (n=30), who will receive standard theoretical empathy education without the simulation component. Outcomes will be assessed immediately before and after the session using the Turkish versions of the Jefferson Scale of Empathy - Nursing Student (JSE-NS), a Communication Skills Inventory, a Patience Scale, the Brief Resilience Scale, and a Patient-Centered Care Competency Scale. The investigators hypothesize that participation in the GENE sensory restriction simulations will produce greater short-term gains in empathy, communication, patience, resilience, and patient-centered care competency than theoretical education alone.

This study examines whether surgical nurses' confidence in managing patients' pain (pain management self-efficacy) is related to how well their patients' pain is managed after surgery. Nurses working in general surgery clinics will complete a questionnaire about their own pain management self-efficacy, and the surgical patients under their care will complete a separate questionnaire about their postoperative pain outcomes. Each patient's responses will be linked to the nurse who cared for them, creating nurse-patient pairs, in order to explore how nurse-level factors relate to patient-level pain outcomes. This is an observational study: no treatment, medication, or intervention is provided or tested; participants only complete questionnaires.

This single-center, prospective before-after (quasi-experimental) study evaluates whether a brief preoperative "Smoke Check" practice improves compliance with surgical smoke evacuation during smoke-generating surgical procedures. The Smoke Check consists of two short safety questions asked by the circulating nurse before a procedure begins: (1) Is surgical smoke expected to be generated during this procedure? and (2) If yes, is an appropriate smoke evacuation system ready for use? The study first observes current practice during a Baseline period without changing existing workflow, and then introduces the Smoke Check into the circulating nurses' preoperative routine during a second (Post-Smoke Check) period, comparing the proportion of smoke-generating procedures with appropriate smoke evacuation use between the two periods. The unit of observation is the surgical procedure, not the patient or staff member, and no patient- or staff-identifying information is collected. The study is grounded in the Association of periOperative Registered Nurses (AORN) Guideline for Surgical Smoke Safety and does not involve any drug, device, or licensed psychometric instrument.